Provider Demographics
NPI:1689751877
Name:THE NEUROSURGERY CENTER, LLC
Entity Type:Organization
Organization Name:THE NEUROSURGERY CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:F
Authorized Official - Last Name:RAGGIO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:337-439-0700
Mailing Address - Street 1:601 S RYAN ST
Mailing Address - Street 2:
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70601-5726
Mailing Address - Country:US
Mailing Address - Phone:337-439-0700
Mailing Address - Fax:337-439-1088
Practice Address - Street 1:601 S RYAN ST
Practice Address - Street 2:
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70601-5726
Practice Address - Country:US
Practice Address - Phone:337-439-0700
Practice Address - Fax:337-439-1088
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA012029207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1448451Medicaid
LA5CB88Medicare ID - Type Unspecified